並列摘要
The diagnosis of acromegaly is based on the typical manifestation and then confirmed biochemical by elevated growth hormone (GH) and insulin-like growth factor I (IGF-1) concentration. However, on rare occasion, the growth-hormone secreting tumor can be clinically obscure, so-called silent somatotropinomas. Our patient was a 40-year-old woman with an initial presentation of lip numbness, but no other external appearance usually found in GH excess status. The basal serum GH level was 12.2ng/ml and serum IGF-1 was 456ng/ml with mild elevated prolactin level of 26.7mg/dl. Her pituitary MRI revealed a microadenoma. The patient received transsphenoidal surgery, and the pathology proved to be a GH-producing pituitary adenoma. After the operation, both the serum GH and IGF-I level were decreased, but still higher than the normal range. Postoperatively, the patient received the octreotide injection therapy. It is suggested that biochemically active somatotroph adenomas may be clinically silently.
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